A 68-year-old man with a 40-pack-year smoking history presents with painless jaundice, weight loss of 8 kg over 3 months, and epigastric pain radiating to the back. CT pancreas protocol shows a firm white-tan mass in the pancreatic head (marked **A**) with distal common bile duct stricture and dilated proximal CBD. The mass demonstrates ≤180° contact with the superior mesenteric vein with maintained patency. Which of the following is the most appropriate next step in management according to current NCCN guidelines?
A 68-year-old man presents with progressive painless jaundice, pruritus, and dark urine for 3 weeks. On examination, a non-tender, palpable gallbladder is noted. Contrast-enhanced pancreas-protocol CT shows a firm, ill-defined grey-white mass in the pancreatic head with concurrent dilatation of the common bile duct and pancreatic duct. The structure marked **B** in the diagram is suspected. Which of the following molecular alterations is the EARLIEST and MOST FREQUENT in the pathogenesis of this lesion?
Ready to test yourself?
Test your Surgery knowledge with AI-powered MCQs and detailed explanations — no signup required to try.
Sign up free and practice all 2 Pancreatic Head Adenocarcinoma MCQs with AI-powered explanations tailored to your performance.
Create Free Account